Overcoming barriers to breast cancer screening among high-risk women

Women today are highly informed regarding breast cancer prevention, but sometimes awareness isn't the barrier to treatment. For those struggling to pay electric bills or buy groceries, scheduling a mammogram isn't high on their priority list.

To help change that dynamic, Kathryn Cardarelli, PhD, Associate Professor of Epidemiology in the School of Public Health, and her team address these issues during eight-week breast health education programs in economically challenged parts of Dallas County. The Dallas Cancer Disparities Research Coalition serves approximately 200 women per year and has earned a three-year grant from the Cancer Prevention Research Institute of Texas.

The coalition's goal is to remove barriers between high-risk women in Dallas and the breast cancer preventive care they need. Things like fear of fatalism, lack of transportation and economic hardship prevent these women from actively seeking screenings. Lay health educators go door-to-door, and more often than not, through the door, to persuade women to participate in the program.

"We meet people where they are - in their homes," Cardarelli said. "Sometimes our staff ends up holding a baby or stirring a pot of food on the stove just to talk to them about the program and encourage them to enroll."

"That's why our program is so different," adds Lay Health Educator Phyllis Harris. "As a team, we've tapped into areas that most programs run from. We're not afraid to go in uncharted territory."

The program participants meet weekly for 90 minutes in a community location to learn how to eat healthy on a budget, how to talk to their doctor, faith and wellness, and methods of early detection, among other things. Upon completing the classes, a graduation ceremony is held to honor the participants' commitment and to encourage them to become community resources.

"The most important thing the program offers is that it teaches participants to value their health and themselves," Cardarelli said.

The grant covers free screening mammograms for each participant who is asymptomatic and has not been screened within the last year. Since the program began in 2007, 24 percent of participants who completed surveys had never received a screening mammogram and 6.8 percent had not received one in the last five years. Upon completion of the program, 82 percent of the women were eligible for a screening mammogram. If screenings show that follow-up is needed, the participants receive more information about next steps.

"I am so proud to see how much of an impact our program has made in the lives of so many women in underserved communities," said Harris.